1. By submitting this form, I am giving Flex Affect my 15 day written notice to cancel my membership.

2. I understand that my membership will be cancelled 15 days from the date this form was submitted and 30% of the remaining balance charged to payment method on file. Should I choose to rejoin Flex Affect after the termination of my membership, (which we hope you do), I will have to pay the current rate at that time.

3. I understand that I will be charged/debited one additional month if I provide less than 15 day notice prior to my next billing period. Upon completion of the 15 day cancellation period, my membership shall then be considered terminated.

4. I understand that if I am requesting to cancel my membership while it is on hold, that the membership will become active and the 15 day cancellation window will begin.

5. I have turned in my membership access card. $10 fee if not turned in.